Lumbar Radiofrequency Ablation (RFA) Procedure
What are Lumbar Facet Joints?
Facet joints connect the vertebrae (the bones of the spine) and help guide the spine during movement. The lumbar region of the spine contains five vertebrae and is located in the lower back.
Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. Lumbar facet joints are named for the vertebrae they connect and the side of the spine where they are found. The L4-5 facet joint, for example, joins the 4th and 5th lumbar vertebrae.
Lumbar Facet Joint Pain
Lumbar facet joint pain is a result of injury, either to the cartilage inside the joint or the connecting ligaments surrounding the joint. Pain from an injured lumbar facet joint may range from muscle tension to more severe pain. Depending on which facet joint is affected, the pain may occur in an area from your lower back down to your buttocks.
What is Lumbar RFA?
During this procedure, radiofrequency energy is used to disrupt function of a lumbar medial branch nerve, so that it can no longer transmit pain signals from an injured facet joint.
You may be given oral Valium or IV (intravenous) medication to help you relax. You may lie down with face down on the procedure table. The lumbar spine is identified under fluoroscopy (a type of X-ray is used to ensure the safe and proper position of the needle). A local anesthetic is used to numb your skin. After the numbing medicine takes effect and with the assistance of a special X-ray machine called a fluoroscope, the doctor will insert a special radio frequency needle. You will feel some dull pressure but not pain. After confirming that the needle tip is in position, a special needle tip (electrode) is inserted. Again, the proper location of the needle is confirmed by fluoroscopy. Using electrical stimulation, the doctor will verify the correct nerve. You will feel a tingling sensation similar to hitting your "funny bone." You may also experience some muscle twitching. The needle tip is then heated by electric current which is passed using the radio frequency machine for 90 to 120 seconds. This will numb the area where the medial nerves are located.
Post RFA Procedure
After the procedure, you may experience some muscle soreness for a few days. If so, you may want to apply ice or a cold compress to the affected area. Do not drive for the remainder of the day. Please have an adult drive you home or accompany you in a taxi or other public transportation. Depending on how you feel, you may resume normal activities and return to work the following day. You may feel sore for one to four days. This is normal, and may be caused by muscle and nerve irritation. Your back may feel numb, weak, or itchy for a couple of weeks. Be patient, as full pain relief normally takes two to three weeks.
How long can I expect pain relief?
You may have pain relief for 6-12 months. Nerves regenerate after an RFA, but how long this takes varies. Your pain may or may not return when the nerves regenerate. If it does, another RFA can be done.